正文 第31章 附錄(16)(2 / 3)

TheHIV/AIDSparadox:Facedwithanepidemicaffectingalreadyvulnerablegroupsinsociety,insusceptibletoeasymedicalsolutions,theearlydaysoftheHIV/AIDSpandemicwereverydifficult.Yettheyproducedaresponsethatinvolvedaddressingaparadox.Paradoxically,themosteffectivewaytoreducethespreadofHIVwasbyprotectingtherightsofthosealreadyinfectedorthosechieflyatriskofinfection.Thiswasaparadoxbecause,inthepast,facedwithepidemics,thenormalresponseofsocietyhadbeenquarantine.BythetimethemagnitudeofHIVwasrecognised,thepossibilityofquarantinehadpassed.Inanycase,giventheslowdevelopmentofHIVinmanyhumans,effectivequarantinewouldhavebeenadisproportionateandineffectiveresponse.

Recognisingtheneedforparadoxicalinitiatives,countriessuchasAustraliabegantakingstepstoaffordlegalandotherprotectionsforpersonsatrisk.Thesestepsincluded:

(1)Introductionofmajorpublichealthinformationcampaignsdiscussingsexualsubjectsopenlyinwaysthatwereunprecedented;

(2)Establishmentofanationalneedleexchangeprogrammeforinjectingdrugusers;

(3)Legalisationordecriminalisationofprostitution(commercialsexwork);

(4)Passageofanti-discriminationlaws;

(5)Thedecriminalisationoflawsagainstsexualminorities.

Inconsequenceoftheseinitiallyradical,andparadoxical,measures,theearlyrapidgrowthofinfectionswithHIVwasturnedaroundincountriesthatadoptedtheseboldmeasures.Thenumberofsero-conversionsquicklyfell.Althoughthereissomeevidenceofariseinrecentyears(usuallyattributedtothedifficultyofmaintainingvigilanceandself-protectionoverlongperiodswithinnewgenerations),thegeneraleffectivenessofthenon-medicalresponseshasbeenwidelyacknowledged.Toasignificantextent,thecountriesthathavetakentheparadoxicalmeasureshavewitnessedafallinsero-conversions.Thosethathavecontinuedtopromote,orpermit,stigma;tocriminaliseadultsexualconductinprivate;andtostigmatizeminoritygroupshavewitnessedacontinuingriseinHIVinfections.